No EHR, right out of the box is ever going to meet most of the needs of any clinician. Finding an EMR to meet one's needs is more about finding one that can be easily and properly customized during implementation than finding a system that already captures your unique view of the world.
SOAPware is in use in over 70 different medical specialties, in all 50 states and over 30 foreign countries. The latest generation of software is arguably unmatched in the industry as to flexibility. Few aspects of the product are unable to be customized and the ability for every user to create their own chart layout and workflows is unique.
Of note, for better or worse, needs are converging. Various certifications, standards, and "pay for performance" initiatives are forcing more consistency and managing expectations.
Our approach to implementation appears to overcome many of the barriers that limited the ability of previous generations of electronic records to meet physician needs.